Let’s act to save our children!

The worldwide epidemic of obesity – even in the face of continuing and increasing malnutrition in many poor countries – shows no evidence of abating, and appears to be increasing here in the Caribbean. At particular risk are our children. This year’s World Obesity Day, promoted by the World Obesity Federation, is dedicated to the URGENT crisis of childhood obesity.

The Federation’s website states: “Child and adolescent obesity has risen rapidly around the world, with few countries taking action against this damaging health issue which affects later health, educational attainment and quality of life”. And it goes on: “This World Obesity Day we are calling for all Governments to meet their commitments to end childhood obesity by 2025.”

In a powerful speech to the Barbados Workers Union on September 30th, Professor Sir Trevor Hassell spoke on the subject. He focused on the epidemic of overweight / obesity among our children, the reasons for it, the serious consequences of the epidemic and actions we need to take to slow and possibly even reverse the epidemic. And he called for urgent and serious discourse and action.

In the WHO Global School Health Survey of 26 schools carried out in Barbados in 2012, the prevalence of overweight was 31.5% and obesity 14.4%, similar to earlier findings of Dr Pamela Gaskin at the Chronic Disease Research Centre, UWI. In her studies of children age 11 to 16, girls were more likely to be overweight and were less physically active than boys from age 13. Professor Hassell also quoted from a report on seven Eastern Caribbean countries showing that between 2000 and 2010, rates of overweight and obesity in children aged 0 to 4 doubled from 7.4% in 2000 to 14.8%. Approximately one third of Caribbean children are overweight or obese, and many studies show that most overweight and obese children become overweight or obese as adults. Their destiny includes one or more of the chronic non communicable diseases or NCDs – diabetes, asthma, hypertension and cardiovascular disease, or the combination known as the Deadly Quartet.

While we usually think of these diseases as diseases of adults, they are being diagnosed among children and the youth with increasing frequency. They affect growth and psychosocial development during adolescence and eventually compromise quality of life and lifespan, and account for nearly 8 out of every 10 deaths in Barbados. Furthermore, the cost to our economy of diseases linked to obesity, such as diabetes and hypertension, is over US$1 billion per annum. Hence the urgency for action.

As Sir Trevor so eloquently said, while a few people are overweight or obese due to hereditary factors, the vast majority are overweight or obese because of external factors – high intake of energy dense but nutrient poor products, high in sugar, fat, and salt – snacks, fast foods sugar filled drinks; and too little physical activity. And he pointed out the issues in and related to schools that needed attention: “advertising and marketing and promotion of junk foods / fast foods, that is, unhealthy foods, by local and international fast food companies; the presence of sugar sweetened drink dispensers; canteens that do not sell and provide adequate selection of healthy food and beverages; absence of water coolers; predominantly unhealthy snacks and other foods sold at school gates; limited opportunities for and participation by students in physical activity; and insufficient education about importance of healthy nutrition.”

Sir Trevor also noted the excessive time spent playing video games, communicating by cell phone or watching television – hence inadequate physical activity; drinking of inadequate water; aggressive marketing of junk foods to children and issues that directly affect parents and providers. He pointed out that the marketing and promotion of fast foods and junk foods and sugar filled drinks in schools often take the form of providing paper to cover books, or calendars, or even banners in class-rooms and bypass parental control. It is an ethical and human-rights concern and as WHO, PAHO and CARPHA and the Healthy Caribbean Coalition have all indicated, should not be permitted in schools.

There are several actions that must be taken urgently in Barbados to slow and hopefully reverse the increase of obesity and overweight among children, which is knowingly compromising and destroying lives, while placing huge burdens on our health services. They include: “increasing the levels of physical activity among school aged children by reintroducing periods of compulsory physical activity; not allowing promotion of junk food in schools; prohibiting sugar sweetened drinks from school premises; ending junk food sponsorship and support of school activities, family and sporting events; reformulating food and drinks high in sugar; taxing sugar sweetened drinks at a level that will result in their being significantly more expensive than healthier options; and increasing fruit and vegetable intake among children, with support for school gardening programmes”. This last can be called a “no brainer”!

The World Federation is calling on all governments TO MEET THEIR COMMITMENTS TO END CHILDHOOD OBESITY BY 2025. I am more ambitious – I say let’s end it by 2020. For the sake of our children.

(Senator Sir Henry Fraser, an Independent member of the Upper House of the Barbados Parliament, is a longstanding physician and retired Dean of the Faculty of Medical Sciences at the University of the West Indies, Cave Hill Campus)

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